In a remarkable document, Republican National Committee Chairman Michael Steele has declared the GOP firmly against efforts to control Medicare spending.
In a carefully parsed op-ed column in the Washington Post, Steele did acknowledge that "Medicare will go deep in the red in less than a decade" and that "we believe that health reform should be fully paid for." But, no, the GOP doesn't want to "do harm to our seniors." Medicare reform may be a good idea, but not now, he suggests. Why would we want to fix Medicare in the context of a health reform?
The rest of Steele's manifesto puts Republicans squarely against ideas that no one has actually proposed. The GOP, I am happy to know, opposes rationing care based on age and it is, um, dead-set against government dictating the terms of end-of-life care. No death panels, of course.
But mostly, Steele says Republicans oppose "government boards that would decide what treatments would or would not be funded." This is extraordinary. Steele seems to be saying that Medicare ought to simply pay for any treatment any senior wants, at any time. So, if I choose to put myself under the care of an herbalist for a stage IV cancer, Medicare would pay, no questions asked. Ten MRIs for the same bum knee? You've got it. Tummy tucks and cosmetic nose jobs? Why not? After all, seniors have a right to look their best too.
Because he is such a fan of Medicare Advantage managed care plans, I assume Steele also believes that this private Medicare insurance ought also to pay for whatever a patient wants. That would, of course, mean even higher government payments to these companies as well.
Interesting, too, that the GOP, which boasts a nearly absolute opposition to abortion, has a very different view about patient rights when it comes to Medicare: "We need to prohibit government from getting between seniors and their doctors," Steele wrote.
This idea that Medicare should be an open-ended entitlement with absolutely no spending restrictions is especially interesting given the GOP's new-found concern about the deficit -- projected by the White House on August 25 at a cumulative $9 trillion over the next decade. This fear, which is perfectly reasonable, did go missing during the eight years of the Bush administration. We deficit hawks are always happy to welcome them back, though.
But no one can seriously think about deficits without addressing Medicare, a program that costs a half trillion dollars a year, absorbs more than 20 percent of all federal tax revenues, and has been growing at more than 7 percent annually over the past decade. Excluding Medicare from discussions about either health care or the deficit is absurd.
Fortunately, Steele speaks for no one important. No sooner had he put out his statement than key Republican senators, including New Hampshire's Judd Gregg, reiterated their long-standing belief that slowing the growth of Medicare costs should be included in any health reform debate. People such as Steele don't make it easy, but perhaps we can still have a serious conversation about a senior's health program that desperately needs reform.